Provider Demographics
NPI:1982677381
Name:NGUYEN, THAI DUC (MD)
Entity Type:Individual
Prefix:MR
First Name:THAI
Middle Name:DUC
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18648 MCKAY DR
Mailing Address - Street 2:STE 200
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338-5724
Mailing Address - Country:US
Mailing Address - Phone:281-446-7316
Mailing Address - Fax:281-446-0551
Practice Address - Street 1:18648 MCKAY DR
Practice Address - Street 2:STE 200
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-5724
Practice Address - Country:US
Practice Address - Phone:281-446-7316
Practice Address - Fax:281-446-0551
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2016-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH11652084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP000QV251Medicaid
C19875Medicare UPIN
TXP000QV251Medicaid